Cleft lip with or without cleft palate

Cleft Lip with or without Cleft Palate

Cleft lip with or without cleft palate is a congenital condition characterized by a split or opening in the upper lip and/or the roof of the mouth (palate). This condition occurs when the facial structures that are developing in an unborn baby do not close completely. Cleft lip and cleft palate can occur on one or both sides of the face and can vary in severity.

Epidemiology

Cleft lip and palate are among the most common congenital malformations. The incidence varies by geographic area and ethnic background. In the United States, the prevalence is approximately 1 in 700 live births. The condition is more common in males than females.

Etiology

The exact cause of cleft lip and palate is not fully understood, but it is believed to be due to a combination of genetic and environmental factors. Risk factors include family history, maternal smoking, diabetes, and certain medications taken during pregnancy.

Pathophysiology

During normal fetal development, the tissues and cells from each side of the head grow toward the center and join together to form the face. If these tissues do not join completely, a cleft can occur. A cleft lip results from the failure of fusion of the maxillary and medial nasal processes, while a cleft palate results from the failure of fusion of the palatal shelves.

Clinical Presentation

Cleft lip and palate can be diagnosed prenatally through ultrasound or at birth. A cleft lip may appear as a small notch in the lip or a large gap that extends up into the nose. A cleft palate may involve only the soft palate or extend into the hard palate.

Complications

Children with cleft lip and palate may experience difficulties with feeding, speech, hearing, and dental development. They are also at increased risk for ear infections and may require multiple surgeries and therapies.

Diagnosis

Diagnosis is typically made through physical examination at birth. Prenatal diagnosis can be made via ultrasound. Further evaluation may include genetic testing and imaging studies.

Management

Management of cleft lip and palate involves a multidisciplinary approach, including surgery, speech therapy, dental care, and psychosocial support. Surgical repair of a cleft lip is usually performed within the first few months of life, while cleft palate repair is typically done before 18 months of age.

Prognosis

With appropriate treatment, most children with cleft lip and palate can lead healthy, normal lives. Early intervention and comprehensive care are crucial for optimal outcomes.

Also see

• Congenital disorder
• Craniofacial surgery
• Speech therapy
• Genetic counseling